Today CMS published its much anticipated federal policy guidance (SMD: 18-002, see NACHC summary here) reiterating its support and describing considerations for states with an interest in pursuing Section 1115(a) Medicaid waivers to implement work and/or community engagement requirements for Medicaid. This effort began last year with a letter from then-Secretary Price and CMS Administrator …
Category: Health Center Regulatory Issues
CMS Releases Rule That Improves Care for Health Center Medicare Patients
The Centers for Medicare and Medicaid Services (CMS) released its final rule on the CY2018 Physician Fee Schedule earlier this month. While this annual rule typically does not impact services for Community Health Centers (because they are not paid on the Physician Fee Schedule), this year’s rule includes some important provisions that boost care for health center …
CMS Issues Informational Bulletins on Waiver Processes
The Centers for Medicare and Medicaid Services’ (CMS’) Center for Medicaid and CHIP Services (CMCS) has issued two informational bulletins on changes to the Section 1115 Medicaid waiver process and State Plan Amendment and 1915 waiver process. The informational bulletins are a follow-up to a March 14 letter from CMS Administrator Seema Verma and then-HHS Secretary …
MACPAC Takes a Look at Health Centers
[UPDATED] Medicaid and CHIP Payment and Access Commission (MACPAC) has released an issue brief on Medicaid payments and health centers as a follow up to their session on “Considering Medicaid Payment to FQHCs” earlier this fall. As background, MACPAC is a non-partisan agency that provides analysis for Congress on Medicaid and CHIP issues including payment, eligibility, enrollment access and quality …
House Subcommittee Focuses on the 340B Program
While other health care related issues have certainly taken up much of the space on Congress’ agenda over the past year, the 340B program can be added to the list of issues at which Congress has taken a closer look at over the past several months. A case in point is the House Energy and Commerce …
Update on MACRA Implementation
By now many of you have heard of the new Medicare Quality Payment Program (QPP), born out of the Medicare and CHIP Reauthorization Act of 2015 (MACRA) that went into effect this year. The QPP completely revamps the way Medicare pays its providers and is made up of two tracks, the Merit-Based Incentive Payment System …
Uncertainty Remains in the Marketplace
On April 13, 2017 CMS issued its final rule designed to make the ACA Marketplaces more appealing to insurers. Under this final rule, starting for the 2018 plan year: The annual Open Enrollment Period will be shortened from 3 months to 6 weeks States will have full authority to determine if an insurer’s network has …
CMS, HHS Send Letter to Governors on Medicaid
Just after her Senate confirmation as Administrator of the Centers for Medicaid Services (CMS), Seema Verma joined HHS Secretary Tom Price in a letter to governors on their commitment to work together to improve the Medicaid program. The letter states that the federal framework for Medicaid has not “kept pace with emerging evidence around the …
The New Medicaid Landscape: How the Administration May Increase Flexibility for States
While it is unclear what changes Congress may make to the Medicaid program, even without further Congressional action, changes are coming to Medicaid. The recent Senate confirmations of Health and Human Services Representative Tom Price as Secretary of Health and Human Services and Seema Verma as Administrator of the Centers for Medicare and Medicaid Services …
CMS Issues Proposed Rule on “Market Stabilization” for the ACA Marketplaces
On February 15, 2017, CMS issued its proposed rule on “market stabilization” in the Affordable Care Act’s Marketplaces. This proposed rule is one of the first issued by the Trump Administration. Below you will find a summary of the major provisions of the proposed rule and can read NACHC’s comments on the proposed rule here. We …